All posts by johnsommersflanagan

Personal Reflections

A Guest Blog Titled “Not Having the Answer is My Answer” by Tara Smart

2 Comments

Not Having the Answer is My Answer

By Tara Smart, Ed.S.

               I returned to graduate school in 2012 after living and working in the professional world for over a decade.  In fact, 12 years ago I graduated from the University of Montana with an Ed.S in School Psychology.  I had survived the onslaught of stress that graduate school threw at me the first time.  While working towards my Ed.S, friends and family often asked “What are you going to do when you graduate?” I always responded—with confidence—that I would be working as a school psychologist.  People often commented that the financial, mental, and emotional stress of graduate school would all be worth it, since I had a solid plan for the future.  Their affirming responses reassured me that I was suffering for a good cause and that it would all be worth it in the end.   I was nearly immune to the stress of everyday life, because I was already living in the future.

This time around, my rendezvous with graduate school is a completely different experience.  I’m now in my second year in the Counselor Education and Supervision Department at the University of Montana, and I fumble over my words every time the question about my future plan gets asked.  And it gets asked quite frequently. Initially I hoped that, over time, my answer would evolve and then flow smoothly from my mouth.  I have come to realize, however, that there is and will be no flow.  I simply don’t know the answer. Instead of receiving affirmation, I watch people’s faces scrunch up and a concerned smile cross their lips.  Their heads tilt and although they utter words of encouragement, their body language shouts that I’m a pitiful soul locked in the dungeons of graduate school purgatory for what seems like no good reason.  This mixed message makes me uncomfortable, so I try to minimize the stress of the situation by reassuring others that I’m okay and that I’ll figure out the answer eventually.

But underneath my reassurance to them, and to me, questions linger: Why do I even feel the need to have an answer to this question?  Why does a confident answer assure others, and more importantly, why do I need it as reassurance for myself? It occurred to me while listening to a mortgage commercial on the radio, that modern society often focuses on looking to the future.  Buying a house, long term care insurance, and retirement planning all promise us that if we make sacrifices today, then we can live a perfect life in the future.  The planned future is always bright and full of potential.  The future—although it obviously hasn’t happened yet, somehow compensates me for painful decisions in the present.  If I don’t like my job, I just look at my retirement account and tell myself to keep on plugging away, because there will happiness at the end of this work rainbow.  For me, in the past, the future was a pretty decent place to live, until I realized I was missing out on the present.

The present is jumping on the trampoline with my boys. That moment is filled with laughter and love. The present is going to Lolo for Sunday dinner with grandparents. It’s typing this blog at the computer with my cat purring on my lap. The present isn’t just hopes and dreams, it is reality.  It’s not always as grand and fantastic as an imagined future, but it’s always real.  I can touch, smell, and experience it. Now, I’ve decided I like the present, even though it’s still a struggle for me to remain here.

Intentionally deciding to remain in the present has implications for how I handle myself. It means I don’t need an answer to the question. It means I’m not failing when I don’t have an answer.  It just means I don’t know yet.

Not knowing yet is different than never knowing.  I trust the present to guide me to the future.  I trust the present to bring me happiness and wisdom. Before, I was good at answering questions about the future because I was good at living in the future.  I wasn’t able to enjoy the present moment. But now I’m living in the present and trusting myself that my future will evolve exactly as it needs to based on how I live each and every day.

When I realized that my discomfort and inability to answer the question was a reflection of an enhanced ability and comfort to stay in the present, my shoulders relaxed and I let out a deep sigh of relief.  I don’t need to know what I’m going to do when I’m done with graduate school, again.  I can enjoy this moment, this day, and this journey. Not having an answer to the question doesn’t mean, as I’d feared, that I’ve foolishly entered graduate school and will waste time and money since there’s no solid plan for the future.  In fact, it has helped me understand that my plan for the future is to live in the present each day because this is a journey that’s worth savoring.

 

Parenting

Happy Opposite Day

Leave a comment

In honor of Opposite Day (which is today, January 25), this is an excerpt from our How to Listen so Parents will Talk and Talk so Parents will Listen book. You can check it out here:

or here:

http://www.wiley.com/WileyCDA/WileyTitle/productCd-1118012968.html

Here’s the excerpt:

“Opposite Day” is a creative, albeit odd, game played by children around the world (http://en.wikipedia.org/wiki/Opposite_Day). Interestingly, this game is often advocated by adults as a means through which children can learn about paradox and inverse relationships. When someone declares, “It’s Opposite Day!” it means that everything stated thereafter holds a meaning directly opposite of the statement’s content. For example, “It’s a beautiful day!” means, “It’s an ugly day!” and “I’m so happy to see you” means “I’m so not happy to see you.” Declaring Opposite Day is complicated, because if it’s already Opposite Day, the declaration is false, which has led some to conclude that declarations of Opposite Day should always begin the day before or just prior to the moment the day begins.

If you’re confused about this, you’re in good company. Although we’re tempted to declare it’s Not Opposite Day, doing so could really mean it is and then we’d have to start emphasizing how much we hope you’re hating this book and how much we hate working with parents and children, and . . . .

More seriously, we bring up Opposite Day primarily because it creatively captures the strong natural tendency for parents to use basic behavior modification principles in ways that are directly opposite to how they should be used. This chapter is designed to help you help parents straighten out—or reverse—their backward behavioral strategies in a child-friendly and parent-friendly manner.

Backward Behavior Modification: Using Boring, Natural, and Logical Consequences and Passionate and Surprise Rewards

As we alluded to in Chapter 4, backward behavior modification is endemic. Not only do parents tend to pay more attention to negative and undesirable behaviors than they do to positive and desirable behaviors, they also tend to do so with greater force or affect—which further complicates the situation. As noted previously, we learned about this complicated problem directly from teenagers who were in trouble for delinquent behaviors (see Chapter 4).

If parents engage in too much anger, yelling, or passion when their children misbehave, several problems can emerge: (1) The child will experience her parent’s passion as reinforcement for misbehavior; (2) the child will feel powerful and in-control of her parent (which is quite strong positive reinforcement); or (3) the parent will feel controlled by the child, or out-of-control, both of which further escalate the parent’s emotional behavior.

To address backward behavior modification problems, we teach parents how to use “Boring Consequences and Passionate Rewards.” The opening case in Chapter 1 is an example of the power of boring consequences. If you recall, the parents of Emma, a very oppositional nine-year-old, reported their “family was about to disintegrate” because of continuous power struggles. However, when they returned for their second consultation session, their family situation had transformed largely as a function of boring consequences. In Chapter 1, we quoted the father’s report on how he found boring consequences to be tremendously helpful. Emma’s mother was similarly positive:

Thinking about and then giving boring consequences helped us see that it was about us and not about our daughter. Before, she would misbehave and we would know she was going to misbehave and so we would go ballistic. Giving boring consequences suddenly gave us back our control over how we reacted to her. Instead of planning to go ballistic, it helped us see that going ballistic wasn’t helping her and wasn’t helping us. It felt good to plan to be boring instead. And the best thing about it was how it made the whole process of giving out consequences much shorter.

The inverse alternative to boring consequences is the practice of passionate rewards. Parents can be encouraged to intentionally pay positive and enthusiastic attention to their children’s positive, desirable, and prosocial behaviors. Passionate rewards include parental responses such as:

  • Applause or positive hoots and hollers
  • Verbal praise (“I am so impressed with your dedication to learning Spanish”)
  • Pats on the back, shoulder massages, and hugs
  • Family gatherings where everyone dishes out compliments

Passionate rewards are especially important for preadolescent children. As you may suspect, because of increased self-consciousness accompanying adolescence, passionate hugs and excessive compliments for a 14-year-old may function as a punishment rather than a reinforcement—especially if the hugging and hooting occurs in front of the 14-year-old’s peers.

Surprise rewards, presuming they’re provided in a socially tactful manner, are extremely powerful reinforcers for children of all ages. For example, with teenagers it can be very rewarding if parents suddenly and without advance notice say something like, “You know, you’ve been working hard and you’ve been so darn helpful that this weekend we’d like to give you a complete vacation from all your household chores or this $20 bill to go out to the movie of your choice with your buddies; which would you prefer?”

Surprise rewards are, in technical behavioral lingo, variable-ratio reinforcements. Across species, this reinforcement schedule has been shown to be the most powerful reinforcement schedule of all. Everyday examples of variable-ratio reinforcement schedules include gambling, golf, fishing, and other highly addictive behaviors where individuals can never be certain when their next response might result in the “jackpot.”

When coaching parents to use surprise rewards (variable-ratio reinforcement schedules), we emphasize that the surprise reward should be viewed as a spontaneous celebration of desirable behavior. Overall, we prefer this informal reinforcement plan over more mechanized sticker charts and reward systems (although we don’t mean to say that these more mechanized systems should never be used; in fact, when children are put in charge of their own reinforcement systems, these systems can be especially effective).

 

Boys and Men, Tough Kids, Tough Kids Cool Counseling

Boys Will Be Boys . . . Unless We Teach Them Something Better

5 Comments

What follows is a reprint from the ACA blog I wrote a couple weeks ago just in case you didn’t catch that. Have an excellent weekend.

Some of you may already be aware of Rosalind Wiseman’s work. She initially became recognized as a national parenting authority with the publication of her popular book, “Queen Bees and Wannabees” (2003).  This book inspired the movie “Mean Girls.” Despite her lack of academic credentials (a B.A. in Political Science from Occidental College), she has done some good work around the topic of girl bullying.

In her latest book, Masterminds and Wingmen: Helping Our Boys Cope with Schoolyard Power, Locker-Room Tests, Girlfriends, and the New Rules of Boy World she ventures into new and exciting territory. But from the perspective of a grown up boy, I think, despite her best intentions, she doesn’t really get the boy world. This is probably because she never was a boy and can only try to understand the internal struggles and experiences of boys from an external perspective. This doesn’t make her effort bad or unimportant . . . but it does limit her reach. For the purposes of this blog, I want to focus on one particular excerpt that I found both ridiculous and potentially damaging.

On p. 87, she wrote:

“It’s important to allow him [your boy] to have a wide range of feelings.  Moms, if he’s feeling so angry that he wants to release his anger by punching a pillow or a punching bag, or going into his room and yelling at the top of his lungs, or playing really loud music, or even playing a violent video game, let him do it.  If he punches the wall, that’s okay too, as long as he isn’t threatening someone else when he’s doing it.  Plus, after he’s calmed down, he can then learn the skill of drywall patching. The bottom line is that a lot of women can be intimidated in the presence of men’s anger (with good reason).  But at the same time, your son needs a healthy outlet to express his anger without feeling like you think he’s a violent, crazy person for having his feelings.”

Let me just say this, “Like OMG. This is like some really gnarly bad advice.”

As you can see, I’m about as good at channeling my inner girl as Wiseman is at channeling her inner boy. To get back to my adult male persona, what I really want to say is that in this short excerpt, Wiseman’s ideas are so limited that I find them disturbing.

Perhaps the worst part is that Wiseman doesn’t seem to understand the basic and crucial difference between emotions and behaviors. It is and should be completely acceptable for all boys and all girls to experience anger. Anger is a natural and inevitable human emotion. But the emotion of anger is not the same as aggressive behavior. The fact is that boys CAN acknowledge and express their anger WITHOUT PUNCHING THINGS. And they SHOULD be expected to NOT PUNCH THINGS.

Let me emphasize this by saying it again: Boys can and should be expected to express their angry emotions without becoming violent or aggressive. It’s absolutely crucial for boys to learn to use their words and to control or inhibit their aggressive behaviors. A big problem with Wiseman’s message is that she’s coaching moms (and other adults) to accept inappropriate and unacceptable aggressive behaviors—from boys. She seems to be advocating the all-American excuse that boys will be boys and so therefore we should tolerate their aggression and not expect anything different. This is an unhelpful and potentially destructive message. Instead, the message from parents and caring adults needs to be: “I accept your angry emotions; but aggressive behavior is unacceptable.”

Part of what Wiseman is suggesting isn’t terrible. The idea of a natural consequence of drywall patching after an unacceptable aggressive outburst is reasonable. And the idea that moms shouldn’t be intimidated in response to their son’s anger or aggression is very important. But there’s a big difference between accepting an emotion and tolerating an aggressive behavior. Boys need to know that punching and destroying things is an unacceptable way to express their anger.

I think one of Wiseman’s limitations is that she’s never experienced anger and aggressive impulses from the inside of a male body.

As for myself:

I remember the last time I punched a wall . . .

I remember the last time I broke down a door . . .

I remember the last time I ripped a cupboard door off its hinges . . .

I also recall the last time I lashed out in anger and used a particularly unacceptable word to describe a woman. And I’m thankful to the person who taught me very clearly and very directly that I was engaging in an unacceptable behavior. It took me one firm but gentle lesson from a caring adult to learn to never use that disparaging word again.

I remember getting laid out as flat as a pancake by a 290 pound offensive tackle at Reser Stadium in 1978. And I remember wanting nothing more than another chance to get him back.

I also remember how I learned to watch my anger instead of acting on it. I remember the lessons my parents taught me. I remember practicing a deep breath and talking with my psychotherapist about my angry rages. I remember learning to deal more constructively with my revenge impulses even though I wanted so badly to give another male a physical pay-back. And I remember NEEDING SOMEONE to set limits on my aggressive behaviors.

It’s not easy for boys to learn to control their behavior. It’s also not easy for boys to learn to talk about anger (rather than acting on it). But this isn’t all about biology and testosterone. It’s also—and perhaps primarily—about the social expectations that most people hold for boys. If we expect and tolerate aggressive behavior as just part of being a boy, then we have very little chance of changing or improving how boys are capable of behaving.

The bottom line for me (and I know this is personalized and not completely unbiased) is that boys need caring and loving adults to raise the bar for them. I needed—and many boys need—higher (not lower) expectations when it comes to dealing with our anger.

My memories (and my counseling and psychotherapy work with boys) inspire my conclusions. Here they are:

IT IS ESSENTIAL for caring and loving adults to actively teach their boys that anger and sadness and fear and guilt and joy are all acceptable and expected emotions.

It’s equally essential for these same caring and loving adults to teach boys that aggressive behavior is NOT ACCEPTABLE.

If we don’t teach boys these lessons, then we’re lowering the bar to the point that we have no right to expect them to behave in civilized and non-violent ways.

And most of us are far better off when boys and men understand and manage their anger—rather than acting on their aggressive impulses.

Please help spread the word that we should expect more (not less or the same old thing) from boys. I know Ms. Wiseman is well-intended, but in this case we need to counter her bad advice with some good ideas.

Cool Counseling, Counseling and Psychotherapy Theory and Practice, Therapy with Adolescents, Tough Kids, Tough Kids Cool Counseling

What You Missed in Cincinnati: Part II

Leave a comment

While in Cincinnati, I ran short on time and we missed a chance to watch a video clip on “Generating Behavioral Alternatives.” And so as a substitute, I’m posting the verbatim script of the clip we were supposed to watch, and although we’ll miss out on discussing, the clip is fun on its own. Here it’s an excerpt from our Counseling and Psychotherapy Theories book and placed in the context of “Problem-Solving Therapy.”

Generating Behavioral Alternatives With an Aggressive Adolescent

As noted previously, problem-solving therapy (PST) focuses on teaching clients steps for rational problem solving. In this case vignette, the therapist (John) is trying to engage a 15-year-old White male client in stage 2 (generating solutions) of the problem-solving model. At the beginning of the session, he client had reported that the night before, a male schoolmate had tried to rape his girlfriend. The client was angry and planning to “beat the s*** out” of his fellow student. During the session, John worked on helping the boy identify behavioral alternatives to retributive violence.

The transcript below begins 10 minutes into the session.

Boy: He’s gotta learn sometime.

JSF: I mean. I don’t know for sure what the absolute best thing to do to this guy is . . . but I think before you act, it’s important to think of all the different options you have.

Boy: I’ve been thinking a lot.

JSF: Well, tell me the other ones you’ve thought of and let’s write them down so we can look at the options together.

Boy: Kick the shit out of him.

JSF: Okay, I know 2 things, actually maybe 3, that you said. One is kick the [crap] out of him, the other one is to do nothing . . .

Boy: The other is to shove something up his a**.

JSF: And, okay—shove—which is kinda like kicking the s*** out of him. I mean to be violent toward him. [Notice John is using the client’s language.]

Boy: Yeah, Yeah.

JSF: So, what else?

Boy: I could nark on him.

JSF: Oh.

Boy: Tell the cops or something.

JSF: And I’m not saying that’s the right thing to do either. [Although John thinks this is a better option, he’s trying to remain neutral, which is important to the brainstorming process; if the client thinks John is trying to “reinforce” him for nonviolent or prosocial behaviors, he may resist brainstorming.]

Boy: That’s just stupid. [This response shows why it’s important to stay neutral.]

JSF: I’m not saying that’s the right thing to do . . . all I’m saying is that we should figure out, cause I know I think I have the same kind of impulse in your situation. Either, I wanna beat him up or kinda do the high and righteous thing, which is to ignore him. And I’m not sure. Maybe one of those is the right thing, but I don’t know. Now, we got three things—so you could nark on him. [John tries to show empathy and then encourages continuation of brainstorming.]

Boy: It’s not gonna happen though.

JSF: Yeah, but I don’t care if that’s gonna happen. So there’s nark, there’s ignore, there’s beat the s**. What else?

Boy: Um. Just talk to him, would be okay. Just go up to him and yeah . . . I think we need to have a little chit-chat. [The client is able to generate another potentially prosocial idea.]

JSF: Okay. Talk to him.

Boy: But that’s not gonna happen either. I don’t think I could talk to him without, like, him pissing me off and me kicking the s*** . . . [Again, the client is making it clear that he’s not interested in nonviolent options.]

JSF: So, it might be so tempting when you talk to him that you just end up beating the s*** out of him. [John goes back to reflective listening.]

Boy: Yeah. Yeah.

JSF: But all we’re doing is making a list. Okay. And you’re doing great. [This is positive reinforcement for the brainstorming process—not outcome.]

Boy: I could get someone to beat the s*** out of him.

JSF: Get somebody to beat him up. So, kind of indirect violence—you get him back physically—through physical pain. That’s kind of the approach.

Boy: [This section is censored.]

JSF: So you could [do another thing]. Okay.

Boy: Someone like . . .

JSF: Okay. We’re up to six options. [John is showing neutrality or using an extinction process by not showing any affective response to the client’s provocative maladaptive alternative that was censored for this book.]

Boy: That’s about it. . . .

JSF: So. So we got nark, we got ignore, we got beat the s*** out of him, we got talk to him, we got get somebody else to beat the shit out of him, and get some. . . . [Reading back the alternatives allows the client to hear what he has said.]

Boy: Um . . . couple of those are pretty unrealistic, but. [The client acknowledges he’s being unrealistic, but we don’t know which items he views as unrealistic and why. Exploring his evaluation of the options might be useful, but John is still working on brainstorming and relationship-building.]

JSF: We don’t have to be realistic. I’ve got another unrealistic one. I got another one . . . Kinda to start some shameful rumor about him, you know. [This is a verbally aggressive option which can be risky, but illustrates a new domain of behavioral alternatives.]

Boy: That’s a good idea.

JSF: I mean, it’s a nonviolent way to get some revenge.

Boy: Like he has a little dick or something.

JSF: Yeah, good, exactly. [John inadvertently provides positive reinforcement for an insulting idea rather than remaining neutral.]

Boy: Maybe I’ll do all these things.

JSF: Combination.

Boy: Yeah.

JSF: So we’ve got the shameful rumor option to add to our list.

Boy: That’s a good one. (Excerpted and adapted from J. Sommers-Flanagan & R. Sommers-Flanagan, 1999)

This case illustrates what can occur when therapists conduct PST and generate behavioral solutions with angry adolescents. Initially, the client appears to be blowing off steam and generating a spate of aggressive alternatives. This process, although not producing constructive alternatives, is important because the boy may be testing the therapist to see if he will react with judgment (during this brainstorming process it’s very important for therapists to remain positive and welcoming of all options, no matter how violent or absurd; using judgment can be perceived and experienced as a punishment, which can adversely affect the therapy relationship). As the boy produced various aggressive ideas, he appeared to calm down somewhat. Also, the behavioral alternatives are repeatedly read back to the client. This allows the boy to hear his ideas from a different perspective. Finally, toward the end, the therapist joins the boy in brainstorming and adds a marginally delinquent response. The therapist is modeling a less violent approach to revenge and hoping to get the boy to consider nonphysical alternatives. This approach is sometimes referred to as harm reduction because it helps clients consider less risky behaviors (Marlatt & Witkiewitz, 2010). Next steps in this problem-solving process include:

  • Decision making
  • Solution implementation and verification

As the counseling session proceeds, John employs a range of different techniques, including “reverse advocacy role playing” where John plays the client and the client plays the counselor and provides “reasons or arguments for [particular attitudes] being incorrect, maladaptive, or dysfunctional” (A. M. Nezu & C. M. Nezu, 2013).

Clinical Interviewing, Cool Counseling, Personal Reflections, Therapy with Adolescents, Tough Kids, Tough Kids Cool Counseling

What You Missed in Cincinnati

2 Comments

For me, the hardest thing about presenting professional workshops is time management. I want participants to comment, but how can I plan in advance for exactly how long their comments will be? Even worse, how can I accurately estimate the length of my own impromptu moments? It seems obvious that there’s a need for spontaneity. I don’t want to cut off potentially valuable comments from participants . . . and I don’t want to cut off my own creative musings either. Clearly, the clock is my workshop enemy.

For example, how could I know in advance that I would suddenly feel compelled to share a personal dream of mine with 85 of my new Cincinnati counselor friends? Never before had I shared with a workshop audience that 45 years-ago I dreamt I was Felix-the-Cat and then while crossing the road (as Felix), I got hit by a car . . . and died.

But then I woke up and have kept on living.

I like to think that particular disclosure is a perfectly normal thing to do when you’ve got a group of professional counselors to listen to you.

The point was to bust the myth that some teenage client have (and will talk about in counseling) that if they dream they die, it is prophetic and means they’ll die soon in real life also.

And beyond my personal dream disclosure, how would I know that one of the participants would have such passion that he would accept an invitation to come up to the microphone and share a physical relaxation technique that he uses with elementary school students.

These are just two samples of the sort of thing you missed because you weren’t in Cincinnati at the Schiff Center on the Xavier University campus yesterday.

But you also missed the start of the workshop where I decided on the spot that it was just the right time and place for me to open the workshop with a story of the most embarrassing moment in my life. It struck me as an awesome idea at the time . . . and it really was the most embarrassing moment of my life . . . until a few hours later when I shared my Felix-the-Cat dream.

There are always bigger mountains to climb.

You also missed meeting my incredibly gracious hosts from the Greater Cincinnati Counseling Association including, Butch Losey (who’s the most humble and understated guy who should be famous I’ve ever met), Kay Russ (who’s right up there with the most responsible person I’ve ever met), and Brent Richardson (who is as irreverent and insightful as ever), and Robert Wubbolding (who may be on his way to Casablanca to do a week long choice theory/reality therapy workshop by the time I post this and yet took eight hours out of his life to attend the workshop anyway).

So that’s just a little taste of what you missed in Cincinnati.

I’ll bet you wish you were there. I know I’m glad I was.

Clinical Interviewing

A Brief History of the Clinical Interview

Leave a comment

This is a short excerpt (pre-publication) from the forthcoming Encyclopedia of Clinical Psychology, edited by R. Cautin and S. Lilienfeld. My coauthors on this were Waganesh Zeleke and Meredith Hood. Waganesh is now at Duquesne University and Meredith is busy working on her dissertation.

This section is an interesting–albeit academically oriented–description of the history of the clinical interview.

A Brief History of the Clinical Interview

The term “interview” was first used in the 1500s to refer to a formal conference or face-to-face meeting. The term “clinical” has origins from around 1780 and is linked to an objective or coldly dispassionate approach to bedside observations and treatment of hospital patients. Although difficult to determine the precise origin of the joining of clinical and interview in modern use, it appears that Jean Piaget (1896 – 1980) was the first psychologist to use a variant of the term clinical interview.

In 1920, as Piaget was working to develop a standardized French version of an English reasoning test with Theodore Simon in the Binet laboratory in Paris, he became more interested in the fundamental nature of children’s thinking than in the ranking of children’s intellectual ability on a standardized test. Realizing that existing psychological research methods were inadequate for studying cognitive development, he began using an interviewing approach that had much in common with psychiatric diagnostic interviews. He referred to his process as the “semiclinical interview” (Elkind 1964). Piaget’s semiclinical interview combined standard and nonstandard questioning as a means for exploring the richness of children’s thought.

Similar to Piaget’s initial efforts to combine a rigorously standardized protocol with spontaneous or unplanned questioning, the definition and implementation of the clinical interview has historically and presently been characterized by tension between a highly structured or protocol-driven interaction versus an unstructured or free-response process. In a report on structured clinical interviews, Abt (1949) provided an early articulation of this dialectical tension inherent to the clinical interview, noting that researchers did not want to lose the rich, projective, and idiosyncratic material obtained in a clinical interview, but also needed reliable interviewing procedures that were quantifiable.

Abt’s comments captured the qualitative vs. quantitative nature of most historical and contemporary controversies concerning the clinical interview. On the one side, adherents to the medical model view the clinical interview as a scientific assessment endeavor, emphasizing its quantitative nature and psychometrics (e.g., reliability and validity). On the other side, many practitioners view the clinical interview as a means for obtaining qualitative and idiosyncratic data about patients, using both the process and the data obtained to strengthen the therapeutic relationship and move toward a culturally and individually tailored intervention. Since the 1940s the clinical interview has been considered as either a method for gathering facts about symptoms that align with a scientifically valid diagnosis or a relational experience designed to understand the subjective world of another. There are some who contend that the clinical interview can and should be both a scientific and relational process (Sommers-Flanagan and Sommers-Flanagan 2012).

Clinical Interviewing, Cool Counseling, Therapy with Adolescents, Tough Kids, Tough Kids Cool Counseling

January is an Excellent Month to Attend Workshops in Cincinnati

Leave a comment

Just in case you’re planning to be in or around the Cincinnati area this weekend, the Greater Cincinnati Counseling Association (GCCA) is offering a day and a half of workshops starting on Friday afternoon, January 10 and two workshops with one of my favorite workshop presenters on Saturday, January 11. Here’s the info:

On Friday, January 10, there are two Ethics workshops to choose from:

2:00-5:15

School Counselor Ethics: Case

Discussions and Current Trends

Tanya Ficklin

Or

2:00-5:15

Ethical and Professional Issues:

Therapeutic Alliance Building and

Ethical Considerations When

Working with Children and

Families

Barbara Mahaffey

On Saturday, January 11, I’m doing two separate ½ day workshops:

Tough Kids, Cool Counseling

John Sommers-Flanagan

Saturday 8:45-12:00

Therapy with adolescents can be immensely frustrating or splendidly gratifying. The truth of this statement is so obvious that the supportive reference, at least according to many adolescents is, “Duh!” In this workshop participants will sharpen their therapy skills by viewing and discussing video clips from actual sessions and participating in live demonstrations. Over 20 specific cognitive, emotional, and constructive therapy techniques will be illustrated and/or demonstrated. Examples include acknowledging reality, informal assessment, the affect bridge, therapist spontaneity, early interpretations, asset flooding, externalizing language, and more. Countertransference and multicultural issues will be highlighted.

Suicide Assessment Interviewing

Saturday 1:00-4:15

John Sommers-Flanagan

Freud once said, “By words one person can make another blissfully happy or drive him to despair.” Ironically, traditional adolescent suicide assessment and intervention procedures overemphasize a pathology-based biomedical model that orients adolescents toward despair. In this workshop suicidal crises are reformulated as normal expressions of human suffering and a specific, positive, and practical approach to adolescent suicide assessment interviewing is described. This contemporary adolescent suicide assessment model has a constructive focus, addresses diversity issues, and integrates differential activation theory and Jobes’s approach to Collaborative Assessment and Management of Suicidality. Specific suicide intervention procedures will be described and reformulated.

You can register for these workshops by phone by calling: 513-688-0092

 

Boys and Men, Counseling and Psychotherapy Theory and Practice, Personal Reflections

Why Evolution is a Bad Explanation for Human Behavior

8 Comments

Nearly every day I hear, read, or see the latest news story about how the human brain is hard-wired to make all humans act in one particular way or another. These stories annoy me because:

  1. They emphasize that all humans are the same and ignore the fact that we’re all unique and, to a large degree, unpredictable.
  2. They imply that humans are unlikely to change or deviate from one another.
  3. They repeatedly claim we’re all hard-wired despite the fact that the human brain has NO WIRES.

Even worse, at the bottom of most of these “Your brain is hard-wired” stories is a mythical evolutionary explanation. This annoys me even more . . . because when it comes to everyday human behavior, evolution makes for very bad explanations. But if you’re listening to what pundits and scientists say in the media, you’d be inclined to believe the opposite of what’s really true about humans.

For mysterious reasons, many scientists—especially evolutionary scientists—want to put humans in a box. They suggest and imply and assert that human behavior is predictable. But the truth is that—apart from breathing—there are very few predictable human behaviors. As decades of controlled psychological experiments have shown, even under laboratory conditions where little choice is possible, scientific predictions typically account for no more that 30-40% of the variation in human behavior. This means that humans are 60-70% unpredictable . . . even under highly controlled conditions.

Aside from being mostly wrong, simple evolutionary and biological explanations for human behavior also often are translated into messages that are generally unhealthy for society. Let’s take one big example.

An especially popular media and science topic is male sexual behavior. The argument usually goes like this: Over millions of years males have become hardwired to be attracted to fertility and novelty in sexual partners. This is because . . . the argument continues . . . males seek to perpetuate their gene-pool. This is why, they say, males are attracted to younger females who exhibit signs of reproductive health. This also explains why males—especially young males—are driven to have sex with multiple female partners.

Given current U.S. social problems—think sexual assault and high divorce rates—it makes little sense to promote the mostly false ideas that males seek sexual novelty to perpetuate their gene pool. This information is unhelpful to women who want safe and stable relationships with men and it’s unhelpful to the majority of men who—in contradiction to evolutionary theory—want safe and monogamous intimate relationships with women (or other men).

Most of the time, most males engage in sexual behavior that’s not at all designed to spread their seed or perpetuate their gene pool. Young men are often strongly motivated to NOT get their girlfriends pregnant. Recent data indicate that many young men are NOT especially interested in engaging in indiscriminate sexual behavior.

Even in a 2011 research study at Syracuse University, 333 undergraduate males apparently hadn’t gotten the memo about being hardwired to want sex with novel partners. When asked, whether they could “. . . imagine themselves enjoying casual sex” these young men showed an average response that was largely in the “undecided” range. Think about that: males from 18-22 years-old at Syracuse University couldn’t really decide if they might enjoy casual sex. This is good news. And it’s not consistent with evolutionary-based myths about contemporary young men.

In the same study, 300+ Syracuse University women reported—in direct contradiction to evolutionary theory—that they had been engaging in casual sexual encounters at approximately the same rate as the males.

And so next time you hear or read or view a media story about how millions of years of evolution explains why human males or females behave one way or another, remember that many immediate conditions can and do override evolutionary-based predictions. Evolution is a generality that may or may not apply to a single organism living in the 21st century. Evolution does not trump choice. And that’s the point: Your choices tomorrow will have much more to do with the situations you’re facing today (and that you’re anticipating tomorrow) than they’ll have to do with yesterday.

Boys and Men, Personal Reflections

Raising Boys in the 21st Century

Leave a comment

As some of you may already know, yesterday I had a blog piece posted on the American Counseling Association website. The piece was titled, “Boys will be Boys . . . Unless we teach them something Better.” Check it out here, if you like: http://www.counseling.org/news/blog

There’s also much more helpful information on “raising boys” on the internet. One example is this featured blog on the Good Men Project website: “How We Can Improve Sex Ed for Boys.” Here’s the link for that: http://goodmenproject.com/featured-content/the-good-life-how-we-can-improve-sex-ed-for-boys/

I hope you’re all doing well in the run-up (as the Brits would say) to some major holiday activity.

John SF

 

Clinical Interviewing, Therapy with Adolescents, Tough Kids Cool Counseling

The Therapist’s Opening Statement (or Question) with Adolescents

1 Comment

           Working with adolescents or teenagers is different from working with adults. In this excerpt from a recently published article with Ty Bequette, we briefly focus on how the opening interaction with an adolescent client might look different than an opening interaction with an adult client. This is from: Sommers-Flanagan, J., & Bequette, T. (2013). The initial interview with adolescents. Journal of Contemporary Psychotherapy, 43(1), 13-22.

            When working with adults, therapists often open with a variation of, “What brings you for counseling” or “How can I be of help” (J. Sommers-Flanagan & Sommers-Flanagan, 2012). These openings are ill-fitted for psychotherapy with adolescents because they assume the presence of insight, motivation, and a desire for help—which may or may not be correct.

Based on clinical experience, we recommend opening statements or questions that are invitations to work together. Adolescent clients may or may not reject the invitation, but because adolescent clients typically did not select their psychotherapist, offering an invitation is a reasonable opening. We recommend invitations that emphasize disclosure, collaboration, and interest and that initiates a process of exploring client goals. For example,

I’d like to start by telling you how I like to work with teenagers. I’m interested in helping you be successful. That’s my goal, to help you be successful in here or out in the world. My goal is to help you accomplish your goals. But there’s a limit on that. My goals are your goals just as long as your goals are legal and healthy.

The messages imbedded in that sample opening include: (a) this is what I am about; (b) I want to work with you; (c) I am interested in you and your success; (d) there are limits regarding what I will help you with. It is very possible for adolescent clients to oppose this opening in one way or another, but no matter how they respond, a message that includes disclosure, collaboration, interest, and limits is a good beginning.

Some adolescent clients will respond to an opening like the preceding with a clear goal statement. We’ve had clients state: “I want to be happier.” Although “I want to be happier” is somewhat general, it is a good beginning for parsing out more specific goals with clients.    Other clients will be less clear or less cooperative in response to the invitation to collaborate. When asked to identify goals, some may say, “I don’t know” while others communicate “I don’t care.”

Concession and redirection are potentially helpful with clients who say they don’t care about therapy or about goal-setting. A concession and redirection response might look like this: “That’s okay. You don’t have to care. How about we just talk for a while about whatever you like to do. I’d be interested in hearing about the things you enjoy if you’re okay telling me.” Again, after conceding that the client does not have to care, the preceding response is an invitation to talk about something less threatening. If adolescent clients are willing to talk about something less threatening, psychotherapists then have a chance to listen well, express empathy, and build the positive emotional bond that A. Freud (1946, p. 31) considered a “prerequisite” to effective therapy with young clients.

Some adolescents may be unclear about limits to which psychotherapists influence and control others outside therapy. They may imbue therapists with greater power and authority than reality confers. Some adolescents may envision their therapist as a savior ready to provide rescue from antagonistic peers or oppressive administrators. Clarification is important:

Before starting, I want to make sure you understand my role. In therapy you and I work together to understand some of the things that might be bugging you and come up with solutions or ideas to try. But, even though I like to think I know everything and can solve any problem, there are limits to my power. For example, let’s say you’re having a conflict with peers. I would work with you to resolve these conflicts, but I’m not the police, and I can’t get them sent to jail or shipped to military school. I can’t get anyone fired, and I can’t help you break any laws. Does that make sense? Do you have any questions for me?

A clear explanation of the therapist’s role and an explanation about counseling process can allay uncertainties and fears about therapy. Inviting questions and allowing time for discussion helps empower adolescent clients, build rapport, and lower resistance.